PMID- 21606083
OWN - NLM
STAT- MEDLINE
DCOM- 20120131
LR  - 20211203
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Linking)
VI  - 32
IP  - 22
DP  - 2011 Nov
TI  - Iron deficiency is associated with adverse outcome in Eisenmenger patients.
PG  - 2790-9
LID - 10.1093/eurheartj/ehr130 [doi]
AB  - AIMS: Iron deficiency is common in patients with Eisenmenger syndrome (ES). This 
      study aimed at evaluating (i) whether iron deficiency is related with adverse 
      outcome, (ii) the determinants of iron deficiency, and (iii) the relation between 
      iron reserves and haemoglobin level in a contemporary cohort of ES patients. 
      METHODS AND RESULTS: All ES patients, older than 18 years, selected from the 
      Belgian Eisenmenger registry, were prospectively followed using a web-based 
      registry. Univariate Cox-regression analysis was performed to evaluate the 
      relation with outcome, defined as all-cause mortality, transplantation, and 
      hospitalisation due to cardiopulmonary causes. Bivariate analysis was performed 
      where applicable. A total of 68 patients with a complete dataset (mean age 36.9 +/- 
      14.2 years; 30.9% male) were included. During a median follow-up time of 3.1 
      years, 21 patients (30.9%) reached the predefined endpoint. New York Heart 
      Association (NYHA) class >/= III (HR 4.76; 95% CI 1.84-12.30; P = 0.001), iron 
      deficiency (HR 5.29; 95% CI 2.04-13.76; P = 0.001), mean corpuscular volume (MCV) 
      (HR 0.94; 95% CI 0.90-0.99; P = 0.021), and mean corpuscular haemoglobin (MCH) 
      (HR 0.87; 95% CI 0.76-0.98; P = 0.027) were related with adverse outcome. The use 
      of oral anticoagulation and frequent phlebotomies were independently related with 
      iron deficiency (P = 0.005 and P = 0.008). In iron-deplete patients, MCV (R = 
      -0.408; P= 0.014) and MCH (R = -0.437; P = 0.026) were inversely related with 
      haematocrit. In patients with low oxygen saturation, iron reserves were related 
      with haemoglobin levels (R = 0.587; P = 0.001). CONCLUSIONS: Iron deficiency was 
      associated with a higher risk of adverse outcome. Moreover, the use of oral 
      anticoagulation OAC and frequent phlebotomies were related to iron deficiency. 
      Patients under anticoagulation should be monitored rigorously for iron 
      deficiency. However, in patients with low oxygen saturations, careful iron 
      substitution to avoid too high haemoglobin levels is suggested.
FAU - Van De Bruaene, Alexander
AU  - Van De Bruaene A
AD  - Congenital and Structural Cardiology, University Hospitals Leuven, Herestraat 49, 
      3000 Leuven, Belgium.
FAU - Delcroix, Marion
AU  - Delcroix M
FAU - Pasquet, Agnes
AU  - Pasquet A
FAU - De Backer, Julie
AU  - De Backer J
FAU - De Pauw, Michel
AU  - De Pauw M
FAU - Naeije, Robert
AU  - Naeije R
FAU - Vachiery, Jean-Luc
AU  - Vachiery JL
FAU - Paelinck, Bernard
AU  - Paelinck B
FAU - Morissens, Marielle
AU  - Morissens M
FAU - Budts, Werner
AU  - Budts W
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110523
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Hemoglobins)
RN  - 0 (Transferrin)
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Adult
MH  - Belgium/epidemiology
MH  - Eisenmenger Complex/blood/*mortality
MH  - Female
MH  - Hematocrit
MH  - Hemoglobins/metabolism
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - *Iron Deficiencies
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Oxygen/blood
MH  - Prognosis
MH  - Prospective Studies
MH  - Registries
MH  - Risk Factors
MH  - Transferrin/metabolism
MH  - Young Adult
EDAT- 2011/05/25 06:00
MHDA- 2012/02/01 06:00
CRDT- 2011/05/25 06:00
PHST- 2011/05/25 06:00 [entrez]
PHST- 2011/05/25 06:00 [pubmed]
PHST- 2012/02/01 06:00 [medline]
AID - ehr130 [pii]
AID - 10.1093/eurheartj/ehr130 [doi]
PST - ppublish
SO  - Eur Heart J. 2011 Nov;32(22):2790-9. doi: 10.1093/eurheartj/ehr130. Epub 2011 May 
      23.